两种β受体阻滞剂对碘-131治疗Graves病伴快速心律失常的疗效观察  

Therapeutic Effect of β-blocker on Graves Disease Accompanied with Tachyarrhythmia during Iodine-131 Treatment

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作  者:周友俊[1] 袁卫红[2] 全新胜[1] 张玲[1] 何美琼[1] 

机构地区:[1]昆明医学院附属延安医院核医学科,云南昆明650051 [2]昆明医学院第二附属院核医学科,云南昆明650031

出  处:《昆明医学院学报》2011年第2期27-30,共4页Journal of Kunming Medical College

基  金:云南省自然科学基金资助项目(2007C072M)

摘  要:目的使用两种β受体阻滞剂对碘-131治疗Graves病(简称GD)伴快速性心律失常患者的临床疗效进行研究比较,以期对该类患者寻求有效安全用药.方法 120例初发GD病伴快速性心律失常患者在给予131碘治疗后,根据心率及入组顺序随机分两组,富马酸比索洛尔(bisoprolol fumarate,B)f为治疗组:心率<110次/min,给予5 mg,1次/d;心率≥110次/min,给予10 mg,1次/d,疗程4周;给予盐酸普萘洛尔(propranolol hydrochloride,Ph)组:心率<110次/min,给予10 mg,3次/d;心率≥110次/min,20 mg,3次/d,疗程同上.结果 1周后,富马酸比索洛尔组心率由(121±12.5)次/min减至(82.7±7.5)次/min,差异有统计学意义(P<0.05);普萘洛尔组心率由(118.5±12.8)次/min减至(92.7±10.5)次/min,差异有统计学意义(P<0.05),Bf组较Ph组心率下降更明显,差异有统计学意义(P<0.05),两组治疗前后FT3、FT4水平比较差异无统计学意义(P>0.05).结论比索洛尔治疗GD伴快速心律失常较普萘洛尔疗效显著,控制GD伴快速心律失常患者的心率作用快速副作用较少,可作为GD伴快速心律失常患者的首选安全用药.Objective To investigate and compare the clinical effects of two kinds of β-blockers on pa- tients with Graves'disease and tachyarrhythmia during Iodine-131 treatment, so as to find effective drugs. Methods 120 patients with Graves' disease accompanied with tachyarrhythmia were randomly divided into 2 groups according to heart rate. Treatment group (Bisoprolol fumarate group) : on the basis of 131 I treatment, the patients were given Bisoprolol fumarate (Merck, Germany) for 4 weeks, patients were given 5 mg, I times /d, when heart rate 〈110 times/min, and 10 mg, 1 times/d, when heart rate 1〉 110 times/rain. Control group(propranolol hydrochloride group) : on the basis of 131 I treatment, the patients were given propranolol hy- drochloride (Shijiazhuang Kang Hewei medicine) for 4 weeks, patients were given 10 mg, 3 times/d, when heartrate〈ll0times/min, and20mg, 3times/d, when heart rate 〉~ ll0times/min. Results Afterlweeks, the heart rates of patients in fumarate bisoprolol group were reduced from (121 + 12.5) times/min to (82.7 ± 7.5) times/rain (P 〈0.05) , and in propranolol hydrochloride group from (118.5±12.8) times/rain to (92.7±10.5) times/rain (P 〈0.05 ). The heart rates decreased more significantly in the treatment group as compared with the control group (P 〈 0.05). There was no significant difference in the levels of FT3 and FT4 between tile two groups before and after treatment (P 〈 0.05). Goriclusiorls Bisoprolol shows more significant effect on Graves' disease accompanied with tachyarrhythmia than propranolol, because it can rapidly control the heart rate of patients with fewer side effects. Bisoprolol can be used as the first line drug tot patients with Graves' disease ac companied with tachyarrhythmia.

关 键 词:比索洛尔 普萘洛尔 碘-131 GRAVES病 快速心律失常 

分 类 号:R541.7[医药卫生—心血管疾病]

 

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